憂慮狀態下，正念作業對廣泛性焦慮症思緒漫遊程度之影響：以大學生樣本為例

Under Worried State, the Effects of Mindfulness Task on Mind Wandering of Generalized Anxiety Disorder: An Example of College Sample

黃敬甯(Ching-Ning Huang)

指導教授 ： 張素凰

國立臺灣大學/理學院/心理學研究所/碩士(2018年)

https://doi.org/10.6342/NTU201800165

摘要

對許多事件或活動過度焦慮與擔憂是廣泛性焦慮症之主要特徵，而因憂慮引發注意力難以集中、坐立不安等症狀，亦為其疾病診斷準則之一。過去研究發現，思緒漫遊在個體將注意力投入處理個人顧慮的歷程中，扮演重要的角色，其可能使廣泛性焦慮症病患容易反覆出現憂慮的想法與負向情緒。而以正念為基礎的介入治療，雖然目前已有療效研究指出該治療法能夠有效緩解廣泛性焦慮症之憂慮與焦慮程度，然而該治療法中憂慮病理的療效機制仍未十分明確。因此，本研究擬探討透過正念療法中的三分鐘呼吸空間正念作業，是否有助於GAD傾向個體在憂慮狀態下，減少負向情緒，以及有較低思緒漫遊的程度。研究一以182名（75名男性、107名女性）在台灣的大學院校就讀之學生為研究對象，藉由相關法探討廣泛性焦慮症、憂慮程度、正念特質與思緒漫遊程度間的關係。研究結果顯示在控制憂鬱程度後，廣泛性焦慮症對憂慮與思緒漫遊有正向影響；憂慮對思緒漫遊亦有正向影響。廣泛性焦慮症對正念有負向影響；正念對思緒漫遊有負向影響。具體而言，廣泛性焦慮症可透過憂慮、正念之中介效果，進而影響思緒漫遊程度。研究二以122名（48名男性、74名女性）在台灣的大學院校就讀之學生為研究對象，為2×3× 3三因子混合設計，其中第一因子為「廣泛性焦慮症傾向」，分為GAD傾向高、低二組；第二因子為「情緒調適介入方式」，分為正念組、專注組與放鬆組三組；第三因子為「時間」，分為實驗作業前（T1）、憂慮引發後（T2）與情緒調適後（T3）三個時間點。研究結果顯示：在負向情緒方面，正念組、專注組與放鬆組在情緒調適後（T3）之負向情緒都顯著較實驗作業前（T1）與憂慮引發後（T2）為低，顯示此三種情緒調適介入方式對負向情緒的修復效果相當；在思緒漫遊程度上，正念組在情緒調適後（T3）之思緒漫遊程度顯著低於專注組與放鬆組，而專注組則與放鬆組沒有顯著差異；正念組在情緒調適後（T3）之思緒漫遊程度亦較憂慮引發後（T2）低；顯示正念組對改善思緒漫遊程度有更好的效果。本研究以此對GAD的病理機制造成的影響進行討論，並嘗試對未來的正念介入與臨床實務應用提出建議。

關鍵字

憂慮 ； 廣泛性焦慮症 ； 思緒漫遊 ； 正念 ； 三分鐘呼吸空間

並列摘要

Excessive anxiety and worry about lots of events or activities are the main features of generalized anxiety disorder. The anxiety and worry associated with difficulty concentrating or restlessness symptoms is also one of the diagnostic criteria. Previous studies found that mind-wandering plays an important role in guiding individual’s attention to personal concern, and rendering GAD patients easily emerging in repeated worried contents and negative emotions. Though mindfulness based intervention therapy has been found to have remarkable efficacy in reducing worry and anxiety level, the mechanisms of change have remained unclear. Therefore, this study aimed to explore that under worried state, whether the three minute breathing space mindfulness practice would help individuals with high GAD tendency decrease their negative emotions and lower their mind-wandering level subsequently. Study 1 aimed to explore the relations between GAD, worry, trait mindfulness and mind-wandering through correlational approach. We recruited 182 participants (male = 75, female = 107) from collage sample of Taiwan. The results revealed that after control the depressive mood, GAD had positive effects on worry and mind-wandering. Worry also had positive effect on mind-wandering. On the other hand, GAD had negative effect on trait mindfulness, and trait mindfulness had negative effects on mind-wandering. We also found that the effect of GAD on mind-wandering was mediated by worry and mindfulness. In study 2, we recruited 122 participants (male = 48, female = 74) from collage sample of Taiwan. Study 2 was an experiment with 2 (GAD tendency: high/ low) × 3 (emotion regulation intervention: mindfulness/ concentration/ relaxation) × 3 (the time point which participants' mind-wandering and emotional state are measured: pre-test/ post-worry induction / post-emotion regulation intervention) mixed factorial design. The results found that at the post-emotion regulation intervention, the negative emotion of the participants in all emotion regulation intervention groups were all significantly decreased compared to pre-test and post-worry induction, indicating there was not significant different between mindfulness, concentration and relaxation groups. As to the mind-wandering levels, at the post-emotion regulation intervention, the mindfulness group showed the significantly lowest level compared with concentration and relaxation groups, whereas the concentration and relaxation group have no significant difference. Mindfulness group showed significantly lower mind-wandering levels at the post-emotion regulation compared with post-worry induction. We concluded that the mindfulness intervention was better than concentration and relaxation intervention for the mind-wandering level regulation. The relations between GAD, worry, mindfulness and the mind-wandering are discussed. The impacts of mindfulness on the psychopathology of GAD are also discussed.

並列關鍵字

worry ； generalized anxiety disorder ； mind-wandering ； mindfulness ； three minute breathing space

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